HomeMy WebLinkAbout2225-zNO, 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
$OUTItOLD, N. Y.
CERTIFICATE OF OCCUPANCY
THIS CERTIFIES that the building located at ..J~'~J~.....{~.OgD, d..~O.~,d ...........................Street
Map No...~ ........ Block No ......~ ....... Lot No....:~r~ .......... .(~.~..e.~.~.~...~.,...~. .....................
conforms substantially to the Application for Building Permit heretofore filed in this office dated
.............................................. ..O.~.~..t......2.~, 19..6.-~. pursuant to which Building Permit No....~.~.~..~..~...
dated ..................................... .0.~.....~..., 19...~.~., was issued, and conforms to all of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is ........
..... ~.. ~.V.~.~..e...m~e... ~.~mil~... ~we.1 l&n~ ...........................................................................................
The certificate is issued to .....~.~.]:.t,...e..~....].~.~...~.:']:...~..~. .................... ~.e.~ ..................................................
(owner, lessee or tenam)
of the aforesaid building.
Building Inspector
FORM NO. 2
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
$OUTHOLD, N. Y.
BUILDING PERMIT
(THIS ,PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
2225 Z
October 23 63
Date ............................................................ , 19 ........
Permission is hereby granted to:
Tony Norkl~ A/C Walter Millis
Orient
Build an additio~ on anexisting dwelling
to
.............................................. ff~'so,~a View'~'J~ ......................................................................
at premises located at ..............................................................................................................................
Orient Poing, N.Y.
October 22 .6...3.
pursuant to opplkafion dated ............................................................. 19.. ., and approved by the
Building Inspector
%.00 Pd Cash
Fee $ ........................
~ TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
E×omined .................... .-/ ..................
~..~..~.. ~, 196-5~
Approved .......................... .K':~.~.., ~9.....~...Perm~t No.....~......°~....~-....~Z....~
Disapproved a/c ............................................................................................
(Bui ding Inspector)c~
Application No ..... ~..°~..,,~, ...~
APPLICATION FOR BUILDING PERMIT
Dote ........................................................ , 19 ................
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building
inspector.
b. Plot plan showing location of Jot and of buildings on premises, relationship to adjoining premises or public streets or
areas, and giving a detailed description of layout c~f property must bedrawn on thediagram which is part of this application.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such
permit shall be kept on the premises available for inspection throughout the progress of the work.
e. No building shall be occupied or used in whole or in pa rt for any purpose whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector.
APPLICATION I~ HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances and regulations.
...... ..............................
(SignatUre of applicant, or name, if a corporation)
........................ ........ ...................
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises ~J '~-..~...~ ~~.,~.~..
If applicant is a corporate, signature of duly authorized officer.
(Name and title of corporate officer)
1. Location of land on which proposed work will be done. Map No: ............................................ Lot No: ....................
Street and Number ..................................................... .~,..~-.~: .~-......~,.~.-~. .....................................................
Municipality
2, State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ...... ..~...~...', ..........................................................................................................
b. Intended use end occupency .................. ..~-....~' ..........................................................................
3. Nature of work (check which applicable): New Building .................. Addition ,.,~ ....... Alteration .............
Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................
4. Estimated Cost ~. ..... Fee ..........................................................................
(to be paid on filing this application)
5. [f dweffing, number of dwelling units ..... ~ ..................... Number of dwelling units on each floor .......................
If garage, number of cars .........................................................................................................................................
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..........................
7. Dimensions of existing structures, if any: Fron,'.....~....~'.........~...... Rear .......................... Depth .....~...~... ............
Height ..... ~ ................... Number of Stories .........................................................................................................
Dimensions of same structure with alterations ar additions: Front
................................ Rear .....?.. ....................
Depth ......./'~....~. .............. Height ................................ Number of Stories ..... ~ ..............................
8. Dimensions of entire new construction: Front / ~ i Rear
........................................................... Depth .
Height ...... ~..~.. ............... Number of Stories ........ J ........................
9. Size of lot: Front ....... ;..~...,O..,~...~ ........ Rear ......~.?..,O...~..../. ....... Depth
10. Date of Purchase ........................................................ Name of Former Owner ....................................................
11. Zone or use district in which premises are stuated ~
12. Does proposed construction violate any zoning law ordinance or reaulation?~...i...~,~.. ....................
13. Name of Owner of premises .'..~...:....~....-~ ......... Address .....~..~ ......... ___ Phone No..'~....%~..'../..*.?.
Name of Architect ........................................ ,.,-,~__ ~ //,'~'"~"'""Address ...... . .................... ,, Phone No ................
~....'~r't/~',~~.Address ......,~.-,~ .............. ", Phone No, O..~../T..:.(..~..'
Name
of
Contractor
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fr
property lines. Give street end block numbers or description according to deed, and show street names and indk
whether interior or corner lot.
STA'EE OF NEW,,YOI~I~,,p ~2 ) S S
COUNTY OF ..~:.....) · ·
(~ame of individual signing *]pplication)
above named He is the ..... ~~ ...............................................................................................................
(Contractor, ~gep4-,, -c~rpcra~'e dff;cer;-etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and
this application; that all statements contained in tl~is application are true to the best of his knowledge and bel
and that the work will be performed in the manner set forth in the, application filed therewith.
Sworn~.~;~t° b'efore__ ~-- ,~me this C?..~...~.... "~'~ ~ ...~..~~
....... ~ ............. day of
Notary Public, .~.,..C~..~2~'~...,~'. .............. County ~/ i~'i'~'nature of applicant)
FORFI NO. 1
TOWN OF sOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Examined .................... ~/...~..., 19......~..
Approved ...................... ~.~2~ .......... , ........ ' No .................................
Disapproved a/c ............................................................................................
................................. .........................
Application No .............................
APPLICATION FOR BUILDING PERMIT
Date ........................................................ , 19 ................
INSTRUCTIONS
a. This application must be completely filled in by typ.ewriter or in ink and submitted in duplicate to the Building
Inspector.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or
areas, and giving o detailed description of layout of property must be drown on the diagram which is part of this application.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such
permit shall be kept on the premises available for inspection throughout the progress of the work.
e. No building shall be occupied or used in whole or in pa rt for any purpose whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances and regulations.
............. ....... ................ ........... .............................
(Signat~,,~'~f applicant, or name, if a corporation)
............................... ,~.,~,,, .~..,,~.<~. ........... ~..f,,,.,~..~.~ ..................
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
.
If applicant is a corporate, signature of duly authorized officer.
(Name and title of corporate officer)
1. Location of land on which proposed work will be done. Map No: ............................................ Lot No: ....................
Street and Number ...................................................... ',:~:~.::,~Z~'......,.::!~.¥...:G..,.¢ ....................................................
Municipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use ond occcpancy .......... , .......................................................................................
b. Intended use and occupancy ......... <~..~,.., ......................................................................................................
3. Nature of work (check which applicable): New Building .................. Addition ....~ ....... Alteration ..............
Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................
4. Estimated Cost ........ ,~-,t,.~..,~_,,~ ................................. Fee~...~.~.~. ..............................................................................
(to be paid on filing this application)
,5. If dwelling, number of dwelling units ..... ./ ...................... Number of dwelling units on each floor .........................
If g~rage, number of cars ..........................................................................................................................................
6. If business, commercial or mixed occupancy, specify nature .and extent of each type of use ............................
7. Dimensions of existing structures, if any: Front.......~....'~,...~.,.?,...f.'Rear .,.~...~..,~..,.~.~..~,,'... Depth ...,~.~..'. ..........
Height ..... .~' ................... Number of Stories .......................................................................................................
Dimensions of same structure with alterations or additions Front ~. ~. ~.... Rear ..... ~. ........ ~.,; .....
Depth ...... ~.~/...L ....... :. Height ..... .~...~...f .............. Number of Stories ..... ~ ..............................
8.
Dimensions of entire new construction: Front ......... ~ .................... Rear ............................Depth ,..~. .................
He~, ....... /.9...: ........... ~b~, o~ S*o,~ ........ / ........................
~ _ ~o~ ' ~o~ , _ , ~.~'
9, ~ize al lot: Pront ................................ Rear ............................ Depth ........................................
~0. Dote o~ Purchase ........................................................Name o~ormer Owner ..............................................
l l. Zone or use dstrct n wbch premses are stunted ~ ~ ' ' '
........................................ ~'"'
12. Does proposed construction violat~any zoning law, ordinance or reau[ationr .......... ; ......................................
] 3. Name o~ Owner o~ prem sas .~Jf.'....~(.~¢~ ......... Add tess .. :.:~:~,...~(~ ...... Phone No.
Name al Architect ............................ ~. , ....Address ............................................ Phone No.
...~.~.,~ , / .' .. ~~ ..............
........................................... ~ 0~.
of Co *ac o ............................................ .....................
PkOT
[_ocote cleorly ~nd distinctly oll buildinos, w~ether existin~ or proposed, ond indlcato oil set-b~ck dimensions frr
property lines. Giro street ond block numbers or description occordin~ to deed~ ond show street n~mes ond indict
whether interior or corner lot.
.5
STA'TE OF NEWc"~OI~I~, , a ) S S
COUNTY OF ...¢ac~./~:Ccf%.....) .'
............ .~..~Jd~-...~....'~~ . being duly sworn, deposes ~nd says that he is the applicc
.... (~,a~f individual~ig~i2'~";~iiL%~'i'~) ...............
above named. He is the ..... ~~~ .....................................................................................................................
(Contractor, -~+~ ff;~ *~
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and f
this application; that all statements contained in this application are true to the best of his knowledge and bell
and that the work will be performed in the manner set forth in the application filed therewith.
Sworn to b~fore me this
...... ~.~ ........... day__ ~°f ....... ~ ........................... 19~...,.. ~- ~ ~~~
................ ........ ......................
~--~ County (J (Signature of app[icant)